Focal therapy of localized prostate cancer

Fujihara, Atsuko; Ukimura, Osamu

doi:10.1111/iju.14991

Cited by 17 publications

(13 citation statements)

References 67 publications

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“…The same association was found in our study, with this factor seeming a possible measure that can help setting up an adequate follow-up strategy and counseling patients on risk of disease recurrence. Although here we do not report on functional outcomes, many groups have reported good results with FT, with 94-100% pad-free rate regarding urinary incontinence and 47-86% erectile function (16).…”

Section: Discussionmentioning

confidence: 68%

Medium-term oncological outcomes of intermediate-risk prostate cancer treated with HIFU or cryotherapy. A single center 10-year experience

Dias

Rodriguez-Sanchez

Colandrea

et al. 2022

Arch Ital Urol Androl

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Objectives: Focal therapies (FTs) are promising techniques for the treatment of localized prostate cancer. We assessed the medium-term oncological outcomes of intermediate-risk prostate cancer (PCa) treated with HIFU or cryotherapy. Materials and methods: One-hundred and fifty consecutive patients with intermediate-risk PCa, treated between 2009 and 2018 at a single center were included. Primary study outcome was failure-free survival (FFS), defined as absence of additional treatment, systemic progression or prostate cancer related death. Results: Thirty-seven (25%) patients underwent cryotherapy and 113 (75%) HIFU. Median age was 69 (IQR 62-72) years, with 36 (24%) presenting palpable disease on rectal examination, and median total PSA of 7.85 (IQR 5.75-10.62) ng/mL. Patients were followed for a median of 61 (IQR 48-82) months. FFS at 2 and 4 years was of 75.6% and 53.6%, respectively. Survival from whole gland or systematic treatment at 2 and 4 years was of 78.9% and 53.9%, respectively. Patients with FFS presented lower total PSA nadir (1.89 vs 3.25 ng/mL, p < 0.001), higher % PSA reduction at 3 months (66.1% vs 49.3%, p < 0.001), and at nadir (75.5% vs 55.8%, p < 0.001). Other characteristics such has the treatment modality, age, prostate size, initial total PSA, cT stage, International Society of Urological Pathology (ISUP), tumor location and biopsy results by region did not differ between patients failing and not failing FT. Complications were uncommon (13%), with only onr (1%) patient having Clavien-Dindo grade > II. No deaths due to treatment were registered. Conclusions: At medium-term, FTs for intermediate-risk PCa presented good oncological results, with an excellent safety profile.

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Section: Discussionmentioning

confidence: 68%

Medium-term oncological outcomes of intermediate-risk prostate cancer treated with HIFU or cryotherapy. A single center 10-year experience

Dias

Rodriguez-Sanchez

Colandrea

et al. 2022

Arch Ital Urol Androl

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“…Thermal-ablation technologies such as cryoablation and microwave coagulation are reportedly effective for controlling clinically signi cant cancer 25 . Such thermal-ablation therapies need a safety margin between the target lesion and anterior rectal wall to avoid rectal injury from thermal energy.…”

Section: Discussionmentioning

confidence: 99%

Increasing rectum–prostate distance using a hydrogel spacer to reduce radiation exposure during proton beam therapy for prostate cancer

Narukawa

Aibe

Tsujimoto

et al. 2023

Preprint

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SpaceOAR®, a polyethylene-glycol hydrogel, reduces rectal radiation exposure during radiation therapy for prostate cancer. This study aimed to investigate the impact of our modified technique of hydrogel insertion, which achieves greater separated distance at prostate-apex, on radiation exposure reduction during proton beam therapy (PBT). We included 330 patients undergoing PBT with the relative biological effectiveness (RBE) of 63 Gray (Gy) for localized prostate cancer, and categorized them into groups 0 (no spacer, n = 141), 1 (separated distance of spacer at the prostate-apex level < 7.5 mm, n = 81), and 2 (distance ≥ 7.5 mm, n = 108). The rectal volumes to receive 30–60 Gy (RBE), was estimated and described as Rectal V30–60 (ml). The Rectal V30–60 (ml) was significantly lower in group 2 than in group 1, and in group 1 than in group 0. After propensity score matching, the multivariate logistic regression analysis revealed that the most significant factor to reduce radiation exposure was our modified technique of hydrogel insertion. Therefore, using a hydrogel spacer to expand the prostate–rectum distance not only at prostate-mid to prostate-base level but also at the prostate-apex level can reduce the radiation exposure in PBT for prostate cancer.

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“…In Japan, the interobserver reliability and diagnostic performance of bpMRI were equivalent to those of mpMRI for the detection of csPC using PI‐RADS v. 2.1 21 . For focal therapy of localized prostate cancer, appropriate patients must be selected using mpMRI and MRITB 22 …”

Section: Role Of Multiparametric Mrimentioning

confidence: 99%

“…21 For focal therapy of localized prostate cancer, appropriate patients must be selected using mpMRI and MRITB. 22…”

Section: Introductionmentioning

confidence: 99%

Current magnetic resonance imaging‐based diagnostic strategies for prostate cancer

Inoue,

Shin

2023

Int J of Urology

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Recent developments in multiparametric MRI and MRI‐targeted biopsy have made it possible to detect clinically significant cancers more accurately and efficiently than ever before. Furthermore, software that enables easy MRI/US image fusion has been developed and is already available on the market, and this has provided a tailwind for the spread of MRI‐based prostate cancer diagnostic strategies. Such precise diagnosis of prostate cancer localization is essential for highly accurate focal therapy. In addition, a recent large‐scale study applying MRI to community screening for prostate cancer has reported its usefulness. By contrast, concerns about overdiagnosis and overtreatment, the existence of inter‐reader variability in MRI diagnosis, and issues with current MRI‐targeted biopsy have emerged. In this article, we review the development of multiparametric MRI and MRI‐targeted biopsy to date and the current issues and discuss future directions.

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Focal therapy of localized prostate cancer

Cited by 17 publications

References 67 publications

Medium-term oncological outcomes of intermediate-risk prostate cancer treated with HIFU or cryotherapy. A single center 10-year experience

Medium-term oncological outcomes of intermediate-risk prostate cancer treated with HIFU or cryotherapy. A single center 10-year experience

Increasing rectum–prostate distance using a hydrogel spacer to reduce radiation exposure during proton beam therapy for prostate cancer

Current magnetic resonance imaging‐based diagnostic strategies for prostate cancer

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